S. Gail Eckhardt, MD, professor and head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center, discusses the wnt pathway and its role in colorectal cancer.

Eckhardt says the wnt pathway is highly mutated in colorectal cancer and has been linked to the regulation of the adenomatous polyposis coli (APC) gene and stem cells.

In addition to being a target to treat colorectal cancer, Echkardt says, the wnt pathway is also an area of interest in pancreatic cancer because of the stem cell component.

As the wnt pathway is redundant and complex, Eckhardt says, a combination approach could be the most beneficial.

In pancreatic cancer, chemotherapy would be used to debulk a tumor before a stem cell-targeted wnt inhibitor is administered, Eckhardt says. In colorectal cancer, the MEK pathway and the wnt pathway are both targeted.

Videos

Dr. Eckhardt on the Wnt Pathway in Colorectal Cancer

S. Gail Eckhardt, MD, Professor and Head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center, discusses the role of angiogenesis inhibitors in the treatment of metastatic colorectal cancer (mCRC), following the approval of aflibercept.

Eckhardt notes that she has not administered the angiogenesis inhibitor aflibercept, not because of bias, but rather due to a lack of a formal comparison to the established angiogenesis inhibitor bevacizumab. Each of these agents possesses a unique toxicity profile in addition to the toxicity associated with the chemotherapy that is co-administered, Eckhardt notes. As such, new side effect management techniques would be required when utilizing each angiogenesis inhibitor.

Without a formal comparison to bevacizumab, Eckhardt remains unsure where to position aflibercept in the treatment sequence for patients with mCRC. There is evidence that bevacizumab works beyond progression, Eckhardt notes, but it remains unclear if aflibercept possesses these same properties. However, clinical trials have shown that aflibercept is effective following bevacizumab. As such, it may be an ideal choice as a second-line treatment.

There are data suggesting that agents targeting angiogenesis can be moved around in the sequence during the treatment of renal cell carcinoma, Eckhardt points out. However, this approach has not been examined for patients with colorectal cancer.

Gail Eckhardt, MD, from the University of Colorado Denver and Health Sciences Center, discusses the future role of aflibercept for patients with metastatic colorectal cancer.

S. Gail Eckhardt, MD

Articles

Dr. Eckhardt on the Wnt Pathway in Colorectal Cancer

Dr. Eckhardt on Angiogenesis Inhibition in Metastatic CRC